How much rates vary
Facilitymedian $2,291 · 10th to 90th $646 to $4,677Professionalmedian $603 · 10th to 90th $363 to $891
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $4,897.79 | Facility | None | $512.86 | $707.95 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $707.95 | Professional | None | $316.23 | $524.81 | $707.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,981.07 | Facility | None | $2,290.87 | $2,290.87 | $3,981.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $102.33 Median $630.96 Typical High $954.99 | Professional | None | $102.33 | $630.96 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $1,000.00 | Professional | None | $331.13 | $537.03 | $1,000.00 |
Health Alliance Plan Setting Facility Modifier None Typical Low $602.56 Median $1,479.11 Typical High $5,754.40 | Facility | None | $602.56 | $1,479.11 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $758.58 | Professional | None | $398.11 | $562.34 | $758.58 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $794.33 | Professional | None | $302.00 | $512.86 | $794.33 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $707.95 | Professional | None | $446.68 | $549.54 | $707.95 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $263.03 Typical High $354.81 | Professional | 52 · Reduced service | $257.04 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $141.25 | Professional | 53 · Discontinued | $102.33 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $398.11 Typical High $524.81 | Professional | 54 · Surgery only | $380.19 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $79.43 Typical High $107.15 | Professional | 55 · Aftercare only | $77.62 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $53.70 Typical High $70.79 | Professional | 56 · Pre-op care only | $51.29 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $371.54 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $354.81 | $371.54 | $489.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $269.15 Typical High $363.08 | Professional | 52 · Reduced service | $257.04 | $269.15 | $363.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $147.91 | Professional | 53 · Discontinued | $102.33 | $107.15 | $147.91 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $398.11 Typical High $549.54 | Professional | 54 · Surgery only | $389.05 | $398.11 | $549.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $79.43 Typical High $109.65 | Professional | 55 · Aftercare only | $77.62 | $79.43 | $109.65 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $53.70 Typical High $74.13 | Professional | 56 · Pre-op care only | $51.29 | $53.70 | $74.13 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $371.54 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $363.08 | $371.54 | $512.86 |
Where Michigan sits
The same service costs 5.8 times more in Alabama than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AL $8,423MT $1,458
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.